Open accounting in self-financing hospital management.

摘要

It was with great interest that I read the manuscript by Rao et ah (2009) on the performance of Afghanistan's Community Health Fund operating at the primary, care level. I fully agree with their thoughtful conclusions that it is important to combine sustainable local financing mechanisms and external financing sources in order to reduce dependence on donor funds. Financial management of a community co-determined hospital is particularly difficult in the rural area. Rural hospitals are more likely to have low income, low costs and limited health care resources (Weaver et ah 1994). Transportation costs, logistics, safe water supply, and electricity from a national grid are some of the factors that influence the balance between payable services and expenditures. Availability of specialists and highly-trained health care personnel willing to work in the rural area is scarce and further reduces the scope of health services provided to the community (Kyaddondo and Whyte 2003). There is need of a transparent financial management system.